Volunteer Application

We are delighted to process this application to volunteer with Resilience Charter School. Please complete this application accurately and completely. Be aware that a check of the FDLE Sexual Predator web site will be performed. We do this to comply with state law and to maximize the safety of our students. You must fill out a new application each year. Thank you for offering your time, talents and skills to enhance the education of our students.

Name

First NameLast Name

Date of Birth

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Phone Number

Area CodePhone Number

E-mail

Occupation

Employer

Emergency Contact

Emergency Contact Phone Number

Area CodePhone Number

Have you ever been convicted, found guilty, entered a plea of nolo contendere (no contest), entered into a deferred prosecution or pre-trial diversion agreement, or had adjudication withheld in a criminal offense other than a minor traffic violation? (DUI is not a minor traffic violation.) Are there any criminal charges now pending against you? Sealed or expunged records must be reported. A “NO” check means “NO” to every statement above.

County & State Arrested:

Date(s):

Nature of Charges:

Name at Time of Charges:

Disposition:

If YES, Co-Director approval will be required before volunteering can begin.

How would you like to help (check all that apply)?:

Please share any additional info about your interests, skills, talents, or areas of expertise:

What days of the week work best for your schedule?:

What time of day works best for your schedule?:

Other

How frequently can you volunteer?:

Other

Do you have any children attending this school?

Relationship to child:

Child(ren) Name(s); Grade(s):

How did you hear about Resilience?

Are you volunteering for a class requirement?

School Name:

Professor's Name:

Course Code:

Total Hours Required:

By signing, I agree to abide by the policies and/or procedures of Resilience Charter School. I understand that the school reserves the right not to place me or to discontinue the use of my services as a volunteer.